Get the free Kidney transplant, living donor evaluation request form - hfhs ... - hfhs-formslibrary

Form #: HFH-94-0784MR-0811rev ... Ford Hospital Kidney Transplant Program requires the following tests for the evaluation of a potential Living Kidney Donor. ... ? Liver Function Test (GOT, SEPT,

How to fill out kidney transplant living donor

How to fill out a kidney transplant living donor form:

1. Contact the transplant center: Reach out to the transplant center where the recipient is being treated to inquire about their specific living donor screening process and request a living donor evaluation form.
2. Obtain the form: The transplant center will provide you with the necessary living donor evaluation form. This form will require you to provide personal and medical information.
3. Complete personal information: Fill in your full name, address, contact information, and date of birth. Provide any other requested details such as social security number or driver's license.
4. Medical history: The form will ask about your medical history, including any previous surgeries, illnesses, or chronic conditions. Be thorough and honest when providing this information as it is important for the evaluation process.
5. Medications: List any medications you are currently taking, including dosage and frequency. This information helps the transplant team assess your overall health and potential risks.
6. Lifestyle habits: Provide information about your lifestyle habits such as smoking, alcohol consumption, and any recreational drug use. These factors can impact the suitability of your kidney for transplantation.
7. Testing and screenings: The living donor evaluation form may require you to undergo various tests and screenings to determine your compatibility as a donor. These may include blood tests, urine tests, imaging scans, and psychological evaluations.
8. Submit the form: Once you have completed all the necessary sections of the form, submit it to the transplant center for review. They will consider your information, along with other factors such as blood type and tissue match, to make a determination.

Who needs a kidney transplant living donor?

1. Individuals with end-stage renal disease: People suffering from end-stage renal disease (ESRD) may require a kidney transplant to improve their quality of life and increase their life expectancy.
2. Patients with kidney failure: Kidney failure can be a result of various conditions such as diabetes, high blood pressure, infections, or inherited kidney diseases. These patients may need a kidney transplant to restore normal kidney function.
3. Candidates not suitable for deceased donor transplant: Some patients may not be suitable candidates for a deceased donor kidney transplant due to factors such as long waiting lists, medical conditions, or previous transplant rejections. In such cases, a living donor kidney transplant becomes a viable option.

It's important to consult with a healthcare professional or transplant center for a thorough evaluation and determination of whether a kidney transplant from a living donor is the right course of action.

For pdfFiller’s FAQs

What is kidney transplant living donor?

A kidney transplant living donor is a person who donates one of their kidneys to another person in need of a kidney transplant.

Who is required to file kidney transplant living donor?

The recipient of the kidney transplant is required to file information about the living donor.

How to fill out kidney transplant living donor?

To fill out information about a kidney transplant living donor, the recipient typically needs to provide details about the donor's medical history, relationship to the recipient, and consent for donation.

What is the purpose of kidney transplant living donor?

The purpose of a kidney transplant living donor is to provide a healthy kidney to a person with kidney failure in order to improve their kidney function and overall health.

What information must be reported on kidney transplant living donor?

Information that must be reported on a kidney transplant living donor may include the donor's name, age, medical history, blood type, and relationship to the recipient.

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